Provider Demographics
NPI:1467670620
Name:HUDSON VALLEY PEDIATRICS
Entity Type:Organization
Organization Name:HUDSON VALLEY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN. ASST.
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRVENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-692-6996
Mailing Address - Street 1:100 CRYSTAL RUN RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4041
Mailing Address - Country:US
Mailing Address - Phone:845-692-6996
Mailing Address - Fax:845-692-2286
Practice Address - Street 1:100 CRYSTAL RUN RD
Practice Address - Street 2:SUITE 107
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4041
Practice Address - Country:US
Practice Address - Phone:845-692-6996
Practice Address - Fax:845-692-2286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty